Hi folks, I'm Bob Schrupp physical therapist, Brad Heineck physical therapist
Together we are the most famous physical therapists on the Internet in our opinion of course Bob
Today Brad, we're gonna talk about the McKenzie method for treating your own knee pain now
We've talked about Robin McKenzie a lot because he's been our mentor with back pain and neck pain
But he also gets into the extremities, and this method is really actually very successful. I just used it on my wife
She thought I was a genius. I go Mckenzie's a genius, your wife thought this? Yeah this is good.
This is good. This is
a step in the right direction so
We're gonna go ahead right after we do this introduction here
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So we're trying to turn things around, so let's start off with the first one Brad the first thing
I want you to do if you're having knee pain is I want you to compare the range of motion in the knee
That's affecting you to the better knee, see if they
Straighten out the same and see if they bend the same
Yeah, well you might be better at this Brad than
I would with your white stripe on there Yeah my wife just got these Bob. What do you think?
Yeah I like then we can see, then we could see some motion a little better than with our drabby black pants
So this you can see you know is the knee going perfectly straight
Or does it not get fully straight and sometimes it's hard to tell, it may be like this for a long time
You're used to it. So you may compare to the other knee. Let's say
This is the one that goes straight and the other one you can see, it just has a slight and sometimes
It's just very very slight
Maybe if one is raised compared to the other
It's tight, and then you can also do the same with bending, you can pull it up, and sometimes
It's a feel isn't it Brad? I like to do this one laying down because you can relax
And you can kind of see
How close does your heel get to your butt on this side? You know like here
I can get it to touch, but say on this one I get this far and I got a gap here
It's very clear. You know it could be one of those measurements, and again sometimes it feels tighter
Yeah
You can just tell, so the whole idea here is McKenzie has like eight nine exercises
And the whole idea is you're gonna try to find the exercise that actually relieves the pain
And this is what you want to look for: if it feels better while you're doing it and after
Obviously, that's a good one to do, is it true
Also that the range of motion improves with the exercise? Right
And if you get even a slight improvement in range of motion in your knee a lot of times that'll result in decreased pain
I mean
They work together, the other thing is let's say it hurts while you're doing the exercise but feels better afterwards
That's still the correct exercise to do okay, so let you stretch out and ow ow
But then you get up and walk out and it's like oh that helps clearly feels better
Then it's okay so the third scenario of course is the pain increases while you're doing it
And it hurts afterwards, no
That's not a good, take that exercise and toss that one, so it's kind of you know you can start off
You can start off try number one, and if it works out fine
And it kind of hits a plateau go to number two number three number four it's kind of a progression here
The first one is real simple Brad you're gonna
Just do active knee extension so you're gonna be in the chair
And you can go ahead, just straighten the knee out hold it for five seconds and then relax
Hold it for five seconds and then relax I can see with this
I'm on a stool, but I would be more comfortable if I had a chair
Probably a chair with armrests
So you have some support like yourself, exactly and you can also do this I wasn't prepared for this
But I'll take this instead, you can put a rolled towel underneath your knee or a coffee can
A big rolled towel here that we just rolled up and you can go ahead and do with the knee extension this way sure one two three
four five and
What you can do
With these is you could do ten of these and you can do them every hour if you want
So if you're in the chair
it's really easy to do it in the office chair and
and see does your knee feel better at the end of the day or the next couple days does it feel better and
again follow the rules, if it feels good when you're done or while you're doing them and
Afterwards it's good, or if it feels good after you're doing them, but again if it hurts while you're doing them and afterwards
You're not gonna do it. Yeah. You're done with it then, all right next one
Let's say that worked out fine but you're still getting some knee pain
Let's go to the next one which is knee extension with overpressure now
Overpressure? Yep, you can actually put your foot up on
Maybe another a stool
Or I don't know another chair would probably be too high wouldn't it, it all depends on the flexibility of the person, but yeah
It is nice to do this one
On a stool that moves a little bit, right it is
Yeah, because it allows the stool to move
So what you gonna do is gonna put pressure
you can put go above the knee and below the knee if you want or you can just go above the knee and you're gonna go
pressure on
pressure off pressure on
Pressure off, we actually have you say the words because that tells you how long to do it, and you're gonna do ten of these
And you can see Bob is above and below the kneecap, that's a good hand placement
Now you can also do it without a stool you can just go ahead and put your
Legs straight on the ground like this and go ahead and pressure on
pressure off pressure on pressure off
So then if that works, and again
You're doing better, the next progression would actually be to do it standing Brad, so you could actually do it on the stool
And you're gonna go pressure on
Pressure off pressure on pressure off or you can go like this
Pressure on keep good posture in your back keep your back straight
This might be good to do in a stairwell
I was just gonna mention that Brad that's exactly what my wife did
She did it on a stairwell and she did this little variation I'm gonna show you right now
So she's on the stairs she
was getting pain on the inside of her knee so I
had her actually turn the leg out like this, you see how my foot is turning, you'd be better for this Brad maybe
you have whites on the bottom
So he's turning his foot out a little bit, and now he's doing the pressure on and pressure off
See if it bends a little or straightens a little more feels a little bit better, if it does that's the option or that's the
Modification we could go this and you can go internal rotation too so you can see in this case
He turned it in, again you're gonna experiment, you're gonna see
which one works, which one works for you, in my case this feels much better.
I don't have a knee problem,
That's a good judge right there to tell alright
The next one is going to be knee flexion, so we did all the straightening now
We're gonna try some knee bending and you're gonna start with that seated so what you're gonna
Do is you're gonna go ahead and grab your ankle like this and you're gonna pull towards you and again do the pressure on
pressure off pressure on
Pressure off now does it matter if you put your hands here or more up here?
It's better at the ankle because you're really gonna get that squeeze, a little more leverage. Yeah, you're gonna get more leverage
I imagine some people might have trouble with that Brad, I don't know if we can use this stretch out strap for that
We recommend the strap a lot of times just for stretching overall and what you could do
Is you could get down here and now you got loops and you can pull it toward you if you're having trouble
If you didn't have a strap you can use a towel
A towel's a little hard to hold onto, but it works
Yep, works out good, so that's gonna be the same thing, you can do these every hour if you want
Obviously you probably won't be able to
but you can do it up to five times a day then maybe you know if you can't do them ever hour and ten repetitions
Is this one we can do a little rotation on too?
I don't know that he mentioned that but I bet you why not? I mean
Well if it's one of those things if you do it
And you get more range of motion and it feels better
We'll call that the Heineck method there you go
So then after you've done it in standing you can also do it of course on a chair. You can go ahead and
Do it like this and stretch forward a little bit like this
And then even believe it or not oh, I forgot to show the one variation Brad with the towel
even when you're seated or when you're
Standing you can actually get up and put a little more leverage, you put a rolled towel underneath you like this and go like this
It's just gonna put a little bit different force on the knee and so you might even try this variation, it's actually gonna
gap that joint, I agree and you could do it standing like this too
Where you would put it underneath, and you know go forward a little bit. They even had people you know
Doing a little bit of this Brad going back onto the knee if they wanted to try that, as long as it
Responds properly feel good while you're doing it and when you're done
So that's basically all the range of motion ones now
They wanted you to start some strengthening too and this is one that they recommended Brad is that they said you could go up
Take your chair up to a door so the door would be like this you're gonna be the door Brad
Here, if this was like a door
Yeah, and I would grab the handles
The knobs and that way I could lower myself down
With control
And I could also pull myself up, so to give you a little bit of
Relief off the foot and I would try to keep your knee again around 90 degrees
As opposed to bent greater than 90, make sure you're wearing footwear so your feet don't slide. Yeah, and make sure the door's gonna
hold you yeah, good strong solid door so
Alright, the next one Brad is you could just do some squatting without the door of course um
You know we might have something for balance. You could go to the cupboard and we're just going to, just some shallow squats
so it doesn't irritate the knee
If you knee's sore this may be way too much, but we'll start shallow, good posture with the upper body, not all hunched over
I have to be honest Brad, I really like the ball on the wall for this yeah
You mind showing this?
Oh on one of the comments
One of our viewers is saying you were doing this and you said your wife
just loves doing these and you like to watch her do these
Something to the effect that it was funny, okay
So I like watching my wife
Do the exercise, well I think that idea was maybe you should be doing it too
Like are you getting stronger because you watch it, yeah, but anyway we do read the comments
We just don't have time to answer em, okay here we go
Look at this. Oh, so you can really keep see
The knee is not going beyond the foot, right it's not here. I got this right here Bob
So he's not going like
That yeah, right we want to get the foot out
Again, you have to have shoes that don't slip on the floor, that's why I didn't want to do it today because I got the slippery shoes
and there we go and then watch from
This far at the most, its pain tolerated, if you get pain then it's time to go back up
Yeah, if it's feeling good
You want to get stronger, even then you don't want to go past 90 degrees in the knee even if it's feeling good
Yeah, I have to be honest
It's almost worthwhile getting a ball just for that reason, I mean seriously just to do squats
Well yeah, and you know me Bob. I'm a big fan of the ball. Yeah
I know you do a lot of exercises on it. You can do some off the stairs, too
You can do what they call one-legged ones where you can just step up from the side up to the up to the stairs
And they even had it where you're going off the front of the step and back
But I don't really like that one Brad. I just don't
Yeah, I would prefer to do the side one
I think the big thing with this is the mechanics of the knee, make sure well
We're looking at that knee stays over the toe and it does not go inward. What I don't like, see how much I'm bending
I'm making an executive decision here. I'm not gonna do that way
All right, remember everybody we can fix just about anything except for a broken heart
You got room to put it up that high? I'm hoping. Maybe I'll put it down
Thanks for watching